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Registration page for the Recruitment of Volunteer Mentors

Thanks for registering your interest in being a Volunteer Mentor to a young person in New Zealand.

When you have completed your details, you are required to click on the "submit" button at the bottom of this form. Once you have done this, you will receive a confirmation email from us. If you do not receive the confirmation email, we have not received your registration.

To commence the screening process as part of your registration, we would like to ask you to download the Ministry of Justice criminal records form. You will need to complete this and mail it to the:
Privacy Unit, Ministry of Justice, National Office, PO Box 2750, Wellington

The questions below will assist in the matching process.
Thanks for making this important investment in New Zealand's young people.

Please note:
All fields marked with * are compulsory.

*I would like to register to be a Mentor : Agree
*Title: (Mr, Ms, Miss, Mrs, Dr, Other)
*Given Name:
*Surname:
*Address:
Suburb:
*City:
*Telephone:
Cell Phone:
*Email:
*Date of Birth:
*Ethnicity / Identity:
(Please tick all categories relevant to you) 		Maori
Pasifika
European
Asian
Other
*Do you have experience in Mentoring a young a person? :
(No experience is necessary) 		Yes
No
*Which category of Mentoring a young person interests you? :

For a brief description on any of these categories, please click here 		Crime Prevention
Personal Development
Education/Employment Transition
Identity & Cultural
Befriending
Other - Please state
*What allocation of time can you commit to Mentoring a Young Person? :
 1 - 3 hours per month
3 - 5 hours per month
5+ hours per month
*Which location can you Mentor in? :
 North Island:
Please specifiy City or Town:

South Island:
Please specifiy City or Town:
*What age group would you like to Mentor? :
 10 yrs - 14yrs
15 yrs - 18 yrs
19 yrs - 24 yrs
No Preference
*What do your interests include? :
Please describe as many as possible (sports, arts, music, other)
*Why do you want to become a Mentor? :
* How did you hear about becoming a Mentor :

Thanks for registering your interest. We will process your registration and will contact you over the next 2 weeks.

If you would like to check-out Mentoring Programmes in your area click here to find one near you.

If you have any questions please do not hesitate to contact us at info@youthmentoring.org.nz.